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The thought of getting your tubes tied (also known as tubal ligation or having a tubectomy) can be scary — even if you’re both certain you’re ready to retire from the baby-making game. But if you’re confident it’s the right decision for you and your family, you can relax and look forward to the perks of this procedure — because there are some good ones. First of all, you and your partner can enjoy jumping into bed together without worrying about getting pregnant. Second, you can kiss those pills, patches, or shots goodbye – along with any pesky birth-control side effects that may have accompanied them. Getting your tubes tied may also slightly lower your risk of ovarian cancer and pelvic inflammatory disease (PID). And on top of all those pros is some good news: Thanks to the Affordable Care Act, insurance companies are required to completely cover the cost of tubal ligation surgery.

So what exactly is tubal ligation surgery?"Getting your tubes tied" is a term used for female sterilization — a surgical procedure designed to permanently make it impossible to become pregnant. During the surgery, a woman’s fallopian tubes are clamped and blocked or, in some cases, clipped and sealed, which prevents eggs from reaching the uterus and blocks semen from traveling up the fallopian tubes. What was once considered major abdominal surgery is happily now a much less invasive surgery that can be done in an outpatient setting. And since the 30-minute procedure will be performed under anesthesia (local, spinal, or general), you won’t feel a thing. The surgery is typically performed by a gynecologist, general surgeon, or laparoscopic surgeon, and can be done at any time — including after childbirth or in combination with any abdominal surgical procedure.

If you’re pregnant and you’re having a C-section, your doctor can actually perform a tubectomy right after your baby is born. And if you’re having a vaginal delivery, you can schedule to have your tubectomy within a 48-hour window after you've given birth. Many surgeons actually prefer to do this surgery after birth because you’re already in the hospital, and your abdominal wall is much more relaxed post-birth.

If you choose not to have your tubectomy performed directly post-birth or along with another abdominal procedure, you can schedule it at any time. Your doctor will most likely recommend that you continue using contraception before the procedure (or start using some for at least one month before the procedure if you’re not already). On the day of your tubectomy, your doctor will also give you a pregnancy test just to be 100 percent sure that you’re not pregnant. After the procedure, you may or may not need to continue additional birth control for a short period of time (your doctor will let you know); some women may need to have a test called hysterosalpingogram about 3 months after the procedure to make sure the tubes are blocked.

Laparoscopic tubal ligation: In this procedure, the abdomen is inflated with gas. This gives the surgeon room to perform the procedure. Next, a fiber-optic scope and other small tools are inserted through a tiny incision in your abdomen.

Minilaparotomy: This type of procedure is most commonly used right after a vaginal delivery. A small incision is made in the abdomen, where the fallopian tubes are slightly lifted up through the incision.

With either method, the tubes are either clamped or blocked off with a small clip or ring. The ligated (or tied) tubes remain in their original location and the incisions are closed with stitches or surgical tape.

What you can expect post-surgery:You’ll most likely be free to go home the day of your surgery, but you’ll be told to rest for 24 hours before resuming your normal routine (though showers are allowed, thankfully). You may experience a few days of some slight vaginal bleeding caused by the movement of your uterus during the procedure (though if you had the procedure after childbirth you’ll have the normal post-delivery bleeding which could go on for days to weeks) and if you had the procedure done laparoscopically, your stomach will be swollen from the gas that was inserted during the procedure but will typically go away on its own over a few days. Try not to touch the incision for at least one week post-surgery to help healing and avoid infection of the incision site. Sex might be particularly painful until about one week post-surgery, but your doctor will likely give you and your partner the green light to go as soon as you’re feeling up to it. Be sure to schedule a follow-up exam with your doctor two weeks after the procedure.

Side Effects:These days, tubal ligation is considered a low-risk operation. But in any procedure, mild side effects can occur. The follow symptoms should subside after a few days:

Abdominal cramps

Gassiness or bloating

Dizziness

Exhaustion

Nausea

Sore throat (from the breathing tube if general anesthesia was used)

If you experience any of the following more serious side effects, contact your doctor immediately:

Fever higher than 101°F

Fainting or feeling faint

Bleeding at the incision site that persists or worsens after 12 hours

Severe abdominal pain that persists or worsens after 12 hours

Bloody or any other discharge from the incision that persists or worsens

Effectiveness:The good news is that tubal ligation has an extremely high rate of effectiveness — 99 percent! Still, there’s a very small chance (a 0.5 percent chance) that you could become pregnant post-surgery — and there’s an increased risk of having an ectopic pregnancy if you do get pregnant after the procedure. But the vast majority of women will have no problems and will find that tubal ligation is a worry-free, permanent method of birth control.

Alternative to Tubal Ligation:A newer permanent birth control option called Essure is an alternative to tubal ligation. It can be performed in the comfort of your doctor’s office and involves neither surgery nor general anesthesia. What happens during this type of sterilization? A doctor places a soft, flexible microinsert into each fallopian tube through the cervix using a catheter (tube). Over the next three months, your body produces scar tissue around the inserts, which serves as a natural barrier within your fallopian tubes. This barrier prevents sperm from reaching the egg. During the three-month period, however, you must continue to use another method of birth control until your doctor confirms that your tubes are effectively blocked.

Best of luck,

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